Provider Demographics
NPI:1083987358
Name:LUDLOW, ALLISON WOOLLEY (NP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:WOOLLEY
Last Name:LUDLOW
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:WEST CEMETERY ROAD
Mailing Address - City:PLYMOUTH
Mailing Address - State:UT
Mailing Address - Zip Code:84330-0100
Mailing Address - Country:US
Mailing Address - Phone:435-458-2404
Mailing Address - Fax:435-458-2361
Practice Address - Street 1:7285 W 21200 N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:UT
Practice Address - Zip Code:84330-0100
Practice Address - Country:US
Practice Address - Phone:435-458-2404
Practice Address - Fax:435-458-2361
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT197716-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily